Obamacare Rationing Begins, States Cut Prescription Drug Benefits

National   |   Steven Ertelt   |   Jul 31, 2012   |   12:04PM   |   Washington, DC

When Democrats in Congress pushed the Obamacare bill through, pro-life groups warned about rationing that could take place as a result. Although liberal groups and the mainstream media laughed at the projections, they are now coming to pass.

A new report from Kaiser Health indicates states are now moving in the director of capping or cutting prescription drug benefits.

Illinois Medicaid recipients have been limited to four prescription drugs as the state becomes the latest to cap how many medicines it will cover in the state-federal health insurance program for the poor.

Sixteen states impose a monthly limit on the number of drugs Medicaid recipients can receive and seven states have either enacted such caps or tightened them in the past two years, according to the Kaiser Family Foundation (KHN is a program of the foundation). The limits vary across the country. Mississippi has a limit of two brand-name drugs. In Arkansas adults are limited to up six drugs a month.

Since June, Alabama has had the nation’s stingiest Medicaid drug benefit after limiting adults to one brand-name drug. HIV and psychiatric drugs were excluded. On Aug. 1 the state will relax the limit to its previous level — four brand-name drugs — after the restriction saved more money than expected and the state received money as part of a settlement with a pharmaceutical company.

Other states with Medicaid drug limits are Arkansas, California, Kansas, Kentucky, Louisiana, Maine, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah and West Virginia.

Rationing issues in Obamacare have long been a concern of pro-life groups. Although the death panels — the voluntary advanced care planning that pro-life advocates have been concerned about because it could have doctors financially motivated to promote less medical care and lifesaving treatment — occupied most of the debate, the National Right to Life Committee says other provisions cause concern.

NRLC has said Obamacare contains “multiple provisions that will, if fully implemented, result in government-imposed rationing of lifesaving medical care.”

The department of Health and Human Services (HHS) will be empowered to impose so-called “quality and efficiency” measures on health care providers, based on recommendations by the Independent Payment Advisory Board, which is directed to force private health care spending below the rate of medical inflation. In many cases treatment that a doctor and patient deem needed or advisable to save that patient’s life or preserve or improve the patient’s health but which runs afoul of the imposed standards will be denied, even if the patient wants to pay for it.

The law empowers HHS to prevent older Americans from making up with their own funds for the $555 billion the law cuts from Medicare by refusing to permit senior citizens the choice of private-fee-for-service plans whose premiums are sufficient to provide unrationed care but which HHS, in its unlimited discretion, disallows. The Obama health care law could thus lead to elimination of the only way that seniors will have to escape rationing — by limiting their right to spend their own money to save their own lives.

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The law instructs and authorizes state bureaucrats to limit the value of the insurance policies that Americans may purchase. Not only will the exchanges exclude policies from competing in an exchange when government authorities do not agree with their premiums, but the exchanges will even exclude insurers whose plans outside the exchange offer consumers the ability to reduce the danger of treatment denial by spending what those government authorities claim to be an “excessive or unjustified” amount.

This will create a “chilling effect,” deterring insurers who hope to compete within the exchanges from offering adequately funded plans even outside of them, so that consumers will find it increasingly difficult to obtain health insurance that offers adequate and unrationed health care.